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Article: High hepatitis B surface antigen levels predict insignificant fibrosis in hepatitis B e antigen positive chronic hepatitis B
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TitleHigh hepatitis B surface antigen levels predict insignificant fibrosis in hepatitis B e antigen positive chronic hepatitis B
 
AuthorsSeto, WK1
Wong, DKH1
Fung, J1
Ip, PPC1
Yuen, JCH
Hung, IFN1
Lai, CL1
Yuen, MF1
 
KeywordsAccuracy
Alanine aminotransferase blood level
Diagnostic test accuracy study
Disease severity
Hepatitis B
 
Issue Date2012
 
PublisherPublic Library of Science. The Journal's web site is located at http://www.plosone.org/home.action
 
CitationPLoS One, 2012, v. 7 n. 8, article no. e43087 [How to Cite?]
DOI: http://dx.doi.org/10.1371/journal.pone.0043087
 
AbstractINTRODUCTION: There is no data on the relationship between hepatitis B surface antigen (HBsAg) levels and liver fibrosis in hepatitis B e antigen (HBeAg)-positive patients with chronic hepatitis B (CHB). METHODS: Serum HBsAg and HBV DNA levels in HBeAg-positive CHB patients with liver biopsies were analyzed. The upper limit of normal (ULN) of alanine aminotransferase (ALT) was 30 and 19 U/L for men and women respectively. Histologic assessment was based on Ishak fibrosis staging for fibrosis and Knodell histologic activity index (HAI) for necroinflammation. RESULTS: 140 patients (65% male, median age 32.7 years) were recruited. 56 (40%) had ALT </=2xULN. 72 (51.4%) and 42 (30%) had fibrosis score </= 1 and necroinflammation grading </= 4 respectively. Patients with fibrosis score </= 1, when compared to patients with fibrosis score >1, had significantly higher median HBsAg levels (50,320 and 7,820 IU/mL respectively, p<0.001). Among patients with ALT </=2xULN, serum HBsAg levels achieved an area under receiver operating characteristic curve of 0.869 in predicting fibrosis score </= 1. HBsAg levels did not accurately predict necroinflammation score. HBsAg >/= 25,000 IU/mL was independently associated with fibrosis score </= 1 (p=0.025, odds ratio 9.042).Using this cut-off HBsAg level in patients with ALT </=2xULN, positive and negative predictive values for predicting fibrosis score </= 1 were 92.7% and 60.0% respectively. HBV DNA levels had no association with liver histology. CONCLUSION: Among HBeAg-positive patients with ALT </=2xULN, high serum HBsAg levels can accurately predict fibrosis score </= 1, and could potentially influence decisions concerning treatment commencement and reduce the need for liver biopsy.
 
ISSN1932-6203
2013 Impact Factor: 3.534
2013 SCImago Journal Rankings: 1.724
 
DOIhttp://dx.doi.org/10.1371/journal.pone.0043087
 
PubMed Central IDPMC3423440
 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorSeto, WK
 
dc.contributor.authorWong, DKH
 
dc.contributor.authorFung, J
 
dc.contributor.authorIp, PPC
 
dc.contributor.authorYuen, JCH
 
dc.contributor.authorHung, IFN
 
dc.contributor.authorLai, CL
 
dc.contributor.authorYuen, MF
 
dc.date.accessioned2012-09-20T07:57:58Z
 
dc.date.available2012-09-20T07:57:58Z
 
dc.date.issued2012
 
dc.description.abstractINTRODUCTION: There is no data on the relationship between hepatitis B surface antigen (HBsAg) levels and liver fibrosis in hepatitis B e antigen (HBeAg)-positive patients with chronic hepatitis B (CHB). METHODS: Serum HBsAg and HBV DNA levels in HBeAg-positive CHB patients with liver biopsies were analyzed. The upper limit of normal (ULN) of alanine aminotransferase (ALT) was 30 and 19 U/L for men and women respectively. Histologic assessment was based on Ishak fibrosis staging for fibrosis and Knodell histologic activity index (HAI) for necroinflammation. RESULTS: 140 patients (65% male, median age 32.7 years) were recruited. 56 (40%) had ALT </=2xULN. 72 (51.4%) and 42 (30%) had fibrosis score </= 1 and necroinflammation grading </= 4 respectively. Patients with fibrosis score </= 1, when compared to patients with fibrosis score >1, had significantly higher median HBsAg levels (50,320 and 7,820 IU/mL respectively, p<0.001). Among patients with ALT </=2xULN, serum HBsAg levels achieved an area under receiver operating characteristic curve of 0.869 in predicting fibrosis score </= 1. HBsAg levels did not accurately predict necroinflammation score. HBsAg >/= 25,000 IU/mL was independently associated with fibrosis score </= 1 (p=0.025, odds ratio 9.042).Using this cut-off HBsAg level in patients with ALT </=2xULN, positive and negative predictive values for predicting fibrosis score </= 1 were 92.7% and 60.0% respectively. HBV DNA levels had no association with liver histology. CONCLUSION: Among HBeAg-positive patients with ALT </=2xULN, high serum HBsAg levels can accurately predict fibrosis score </= 1, and could potentially influence decisions concerning treatment commencement and reduce the need for liver biopsy.
 
dc.description.naturepublished_or_final_version
 
dc.identifier.citationPLoS One, 2012, v. 7 n. 8, article no. e43087 [How to Cite?]
DOI: http://dx.doi.org/10.1371/journal.pone.0043087
 
dc.identifier.doihttp://dx.doi.org/10.1371/journal.pone.0043087
 
dc.identifier.hkuros208878
 
dc.identifier.issn1932-6203
2013 Impact Factor: 3.534
2013 SCImago Journal Rankings: 1.724
 
dc.identifier.issue8, article no. e43087
 
dc.identifier.pmcidPMC3423440
 
dc.identifier.pmid22916211
 
dc.identifier.scopuseid_2-s2.0-84865176357
 
dc.identifier.urihttp://hdl.handle.net/10722/164323
 
dc.identifier.volume7
 
dc.languageeng
 
dc.publisherPublic Library of Science. The Journal's web site is located at http://www.plosone.org/home.action
 
dc.publisher.placeUnited States
 
dc.relation.ispartofPLoS One
 
dc.relation.referencesReferences in Scopus
 
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License
 
dc.subjectAccuracy
 
dc.subjectAlanine aminotransferase blood level
 
dc.subjectDiagnostic test accuracy study
 
dc.subjectDisease severity
 
dc.subjectHepatitis B
 
dc.titleHigh hepatitis B surface antigen levels predict insignificant fibrosis in hepatitis B e antigen positive chronic hepatitis B
 
dc.typeArticle
 
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<contributor.author>Wong, DKH</contributor.author>
<contributor.author>Fung, J</contributor.author>
<contributor.author>Ip, PPC</contributor.author>
<contributor.author>Yuen, JCH</contributor.author>
<contributor.author>Hung, IFN</contributor.author>
<contributor.author>Lai, CL</contributor.author>
<contributor.author>Yuen, MF</contributor.author>
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<description.abstract>INTRODUCTION: There is no data on the relationship between hepatitis B surface antigen (HBsAg) levels and liver fibrosis in hepatitis B e antigen (HBeAg)-positive patients with chronic hepatitis B (CHB). METHODS: Serum HBsAg and HBV DNA levels in HBeAg-positive CHB patients with liver biopsies were analyzed. The upper limit of normal (ULN) of alanine aminotransferase (ALT) was 30 and 19 U/L for men and women respectively. Histologic assessment was based on Ishak fibrosis staging for fibrosis and Knodell histologic activity index (HAI) for necroinflammation. RESULTS: 140 patients (65% male, median age 32.7 years) were recruited. 56 (40%) had ALT &lt;/=2xULN. 72 (51.4%) and 42 (30%) had fibrosis score &lt;/= 1 and necroinflammation grading &lt;/= 4 respectively. Patients with fibrosis score &lt;/= 1, when compared to patients with fibrosis score &gt;1, had significantly higher median HBsAg levels (50,320 and 7,820 IU/mL respectively, p&lt;0.001). Among patients with ALT &lt;/=2xULN, serum HBsAg levels achieved an area under receiver operating characteristic curve of 0.869 in predicting fibrosis score &lt;/= 1. HBsAg levels did not accurately predict necroinflammation score. HBsAg &gt;/= 25,000 IU/mL was independently associated with fibrosis score &lt;/= 1 (p=0.025, odds ratio 9.042).Using this cut-off HBsAg level in patients with ALT &lt;/=2xULN, positive and negative predictive values for predicting fibrosis score &lt;/= 1 were 92.7% and 60.0% respectively. HBV DNA levels had no association with liver histology. CONCLUSION: Among HBeAg-positive patients with ALT &lt;/=2xULN, high serum HBsAg levels can accurately predict fibrosis score &lt;/= 1, and could potentially influence decisions concerning treatment commencement and reduce the need for liver biopsy.</description.abstract>
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<subject>Accuracy</subject>
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<subject>Disease severity</subject>
<subject>Hepatitis B</subject>
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Author Affiliations
  1. The University of Hong Kong